Health

More and more families are confronted with price shocks for life-saving pediatric medicines

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For years, Meghan paid Neri $30 a pop for packs of epinephrine auto-injectors for her two growing children with food allergies. The price for four packs of the life-saving drug was a manageable $120 a year.

Neri, 42, of Scituate, Massachusetts, was shocked when her family’s pharmacist told her in 2019 that each auto-injector pack would cost $600.

Her expenses for the year had skyrocketed to $2,400.

The price of the adrenaline shots themselves hadn’t increased. The problem was that Neris had switched to a new high-deductible health plan to save money. Monthly payments are lower for programs with high deductibles, but families must pay thousands of dollars each year before many costs — often including epi auto-injectors — are covered.

As with the Neris, many families are surprised by the price jump. Some are being forced to ration auto-injectors or phase them out altogether.

“Many families have chosen not to pick up their EpiPens because they cannot afford it,” said Dr. Purvi Parikh, an allergist and immunologist at NYU Langone Health in New York City. “They are taking the risk, God forbid, that there will be a bad outcome.”

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Parikh said families have had to take increasing financial responsibilities over the past decade, especially as high-deductible insurance plans have become more common.

The Affordable Care Act of 2010 expanded access to health insurance and required companies to cover more people than ever before. To compensate, “insurers not only increased the cost of coverage, they passed more of it on to patients in the form of high-deductible plans,” Parikh said. “We’ve seen that every year for at least seven to ten years.”

An analysis by the KFF, also known as the Kaiser Family Foundation, found that in 2009, 17% of workers were enrolled in health insurance with an annual deductible of at least $1,000. In 2021 it was 50%.

“The average deductible in employer-based health insurance is now over $1,700 per person,” said Larry Levitt, executive vice president of KFF.

For some family plans, deductibles can be well over $3,000.

“That means even if you have insurance, you might not really be protected from potentially catastrophic healthcare costs,” Levitt said.

Prescriptions that used to cost no more than about $30 — a basic co-payment — are now available at full price, which can climb to hundreds of dollars. Some medications such as B. Medication to control high blood pressure is already covered before the deductible is met. But the epinephrine auto-injectors — which deliver a shot of adrenaline and are the only emergency medication available for life-threatening allergic reactions — usually aren’t.

Few prescription drugs or devices symbolize rising healthcare costs more than EpiPen.


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